Nelson and his colleagues collected the addresses of 300 children admitted to Cincinnati Children’s Hospital with suicidal behavior over three months in early 2016, looking for patterns. Almost instantly, a disturbing one emerged: Price Hill, a poor community with a high rate of opioid overdoses, was home to a startling number of suicidal kids.

Now Nelson is working with county coroners across the nation to try to corroborate his theory, that trauma from the nation’s opioid epidemic could help explain an extraordinary increase in suicide among American children. Since 2007, the rate of suicide has doubled among children 10 to 14, according to the Centers for Disease Control and Prevention. Suicide is the second-leading cause of death between the ages of 10 and 24. The suicide rate among older teenage girls hit a 40-year high in 2015, according to newly released data from the National Center for Health Statistics.

“At any given time, at least 25 percent of my hospitalized kids have a parent actively struggling with addiction,” Nelson said. “Early childhood trauma has been proven to set the stage for a lot of mental and physical illness. It’s a pretty simple scale.”